Carga do câncer de laringe e fatores associados no Brasil e unidades de federação, 1990 - 2019

Abstract

Larynx cancer is one of the most common head and neck cancers, whose main risk factors are smoking and alcohol use, and its occurrence and prognosis depend on adequate and timely preventive measures. This study aimed to investigate the burden of larynx cancer as well as risk factors in the years 1990 to 2019 in Brazil and its states. Two subsequent studies were performed, both based on estimates from the Global Burden of Disease Study 2019 (GBD 2019). The first study analyzed the trends of incidence, mortality and disabilityadjusted life years (DALYs) for larynx cancer between 1990 and 2019, besides the mortalityto-incidence ratio and sociodemographic index. In the second study, data on deaths and DALYs for laryngeal cancer attributable to occupational (FROs) and behavioral risk factors (FRCs: alcohol and tobacco) in Brazil and states in the years 1990 and 2019 were analyzed. Incidence and mortality due to larynx cancer in Brazil, which are approximately eight-fold higher for men, showed a declining trend between 1990 and 2019 (APPC: -0.4% and -1.0%, respectively). For the states of Brazil in 2019, the higher age-standardized incidence rate (Rio Grande do Sul, 3.83 cases per 100,000 inhabitants) is twice the lowest rate (Piauí, 1.56 cases per 100,000 inhabitants). The DALYs also showed negative variation between 1990 and 2019 for both sexes in Brazil, mainly due to the decrease in premature deaths, with the greatest reduction in the state of São Paulo. On the other hand, an increase in this estimate was observed in some states such as Bahia and Rio Grande do Norte. As for occupational risk factors, sulfuric acid was the main carcinogen for laryngeal cancer, with higher rates of DALYs and deaths being observed in men aged 60 to 64 years. There was a reduction in estimates attributable to both tobacco (FRC) and FROs in the country, with inequalities between Brazilian states and an increase in indicators in states in the North and Northeast regions. A fall in the burden of larynx cancer was observed in Brazil over the past 30 years, which may be attributed to a reduction in smoking and to an improvement in treatment. The reduction in mortality rates and DALYs for laryngeal cancer attributable to FROs showed lower percentages than those observed in rates attributable to tobacco, which reinforces the need to expand and reinforce regulatory measures to reduce the disparity between Brazilian states.